<!DOCTYPE html>
<html>

<head>
    <meta charset="utf-8">
    <title></title>
    <meta name="renderer" content="webkit">
    <meta http-equiv="X-UA-Compatible" content="IE=edge,chrome=1">
    <meta name="viewport"
        content="width=device-width, initial-scale=1.0, minimum-scale=1.0, maximum-scale=1.0, user-scalable=0">
    <link rel="stylesheet" href="../../../layuiadmin/layui/css/layui.css" media="all">
    <link rel="stylesheet" href="../../../layuiadmin/style/admin.css" media="all">
</head>

<body>
    <div class="layui-fluid">
        <div class="layui-row layui-col-space15">
            <div class="layui-col-md12">
                <div class="layui-card">
                    <div class="layui-card-header">危险作业登记</div>
                    <div class="layui-card-body">

                        <div class="layui-form" lay-filter="layuiadmin-form-admin" id="layuiadmin-form-admin"
                            style="padding: 20px 30px 0 0;">



                            <div class="layui-form-item">
                                <div class="layui-inline">
                                    <label class="layui-form-label">危审类型</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="phone" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="layui-form-label">工程名称</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="email" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="layui-form-label">施工单位</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="email" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                            </div>


                            


                            <div class="layui-form-item">
                                <div class="layui-inline">
                                    <label class="layui-form-label">申请单位</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="phone" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="layui-form-label">作业地点</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="email" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="layui-form-label">申请部门</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="email" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                            </div>
                            


                            <div class="layui-form-item">
                                <div class="layui-inline">
                                    <label class="layui-form-label">级别种类</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="phone" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="layui-form-label">开始日期</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="email" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="layui-form-label">开始时间</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="email" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                            </div>
                            


                            <div class="layui-form-item">
                                <div class="layui-inline">
                                    <label class="layui-form-label">结束日期</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="phone" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="layui-form-label">结束时间</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="email" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                            </div>
                            
                            
                            <div class="layui-form-item">
                                <div class="layui-inline">
                                    <label class="layui-form-label">原因/内容</label>
                                    <div class="layui-input-block">
                                        <input type="text" name="phone" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                            </div>
                            
                            <div class="layui-form-item">
                                <div class="layui-inline">
                                    <label class="layui-form-label">防护措施</label>
                                    <div class="layui-input-block">
                                        <input type="text" name="phone" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                            </div>
                            
                            <div class="layui-form-item">
                                <div class="layui-inline">
                                    <label class="layui-form-label">防护器材</label>
                                    <div class="layui-input-block">
                                        <input type="text" name="phone" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                            </div>


                            <div class="layui-form-item">
                                <div class="layui-inline">
                                    <label class="layui-form-label">申请人员</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="phone" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="layui-form-label">监护人员</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="email" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                            </div>
                            



                            <div class="layui-form-item">
                                <div class="layui-inline">
                                    <label class="layui-form-label">告知人</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="phone" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="layui-form-label">被告知人</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="email" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                            </div>
                            


                            <div class="layui-form-item">
                                <div class="layui-inline">
                                    <label class="layui-form-label">申请时间</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="phone" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                                <div class="layui-inline">
                                    <label class="layui-form-label">紧急联系电话</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="email" autocomplete="off" class="layui-input">
                                    </div>
                                </div>
                            </div> 


                            <div class="layui-form-item">
                                <div class="layui-block">
                                    <label class="layui-form-label">附件</label>
                                    <div class="layui-input-inline">
                                        <input type="text" name="phone" autocomplete="off" class="layui-input">

                                    </div>
                                    <button type="reset" class="layui-btn layui-btn-primary">点击上传</button>
                                </div>
                            </div>

                            <div class="layui-form-item">
                                <div class="layui-block">
                                    <label class="layui-form-label">备注</label>
                                    <div class="layui-input-block">
                                        <textarea name='x' class="layui-textarea"></textarea>
                                    </div>
                                </div>
                            </div>
                            
                            <div class="layui-form-item">
                                <div class="layui-block">
                                    <label class="layui-form-label">风险种类</label>
                                    <div class="layui-input-block">
                                        <input type="checkbox" name="" title="容器爆炸" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="起重伤害" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="高出坠落" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="坍塌" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="锅炉爆炸" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="淹溺" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="瓦斯爆炸" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="透水" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="物体打击" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="火灾" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="触电" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="中毒和窒息" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="车辆伤害" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="其他伤害" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="放炮" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="机械伤害" lay-skin="primary"> 
                                        <input type="checkbox" name="" title="灼烫" lay-skin="primary"> 

                                    </div>
                                </div>
                            </div>


                            <div class="layui-form-item">
                                <div class="layui-input-block">
                                    <button class="layui-btn" lay-submit=""
                                        lay-filter="component-form-element">保存</button>
                                    <button type="reset" class="layui-btn layui-btn-primary">重置</button>
                                </div>
                            </div>
                        </div>
                    </div>
                </div>
            </div>
        </div>

        <script src="../../../layuiadmin/layui/layui.js"></script>
        <script>
            layui.config({
                base: '../../../layuiadmin/' //静态资源所在路径
            }).extend({
                index: 'lib/index' //主入口模块
            }).use(['index', 'table', 'form'], function () {
                var admin = layui.admin, form = layui.form, table = layui.table;
               
 
            });
        </script>
</body>

</html>